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Machine learning-based prediction of malignant transformation within 5 years in patients with oral leukoplakia: A retrospective cohort study

Oral leukoplakia (OLK), a potentially malignant oral disorder, has 7.2 - 9.8 % transformation rate. Identifying high-risk patients within 5 years can reduce the oral cancer burden. In this retrospective study, we aimed to identify the factors associated with malignant transformation in Chinese patients with OLK and develop and evaluate machine learning (ML) models for predicting malignant transformation within 5 years. In total, 672 OLK patients (203 showing transformation; 469 with no transformation) were inclu…

By the Truvace desk2 min read1 sourcePeer-reviewedTRV-2026-1956· cite & verify
Machine learning-based prediction of malignant transformation within 5 years in patients with oral leukoplakia: A retrospective cohort study
Autopsy Manual by U.S. DEPARTMENTS OF THE ARMY, THE NAVY, AND THE AIR FORCE. Public domain

In brief

Researchers analyzed records of 672 Chinese patients with oral leukoplakia, 203 of whom later developed malignancy. They trained six algorithms on 17 clinicopathological features and tested them on held-out data and on a later cohort of 73 patients.

The work suggests routine clinical variables could help flag patients at higher risk of oral cancer, so that monitoring can be focused on them. The temporal validation group was small and the findings come from one retrospective dataset, so the models are not yet ready for clinical use.

Main points

  1. LightGBM performed best with 17 features, with accuracy of 82.65 percent and an AUC of 0.8524 in the internal test set.
  2. In the temporal validation cohort, LightGBM reached an AUC of 0.7959 using all 17 features.
  3. With only five features, XGBoost reached AUCs of 0.8081 internally and 0.8092 in temporal validation.
  4. For the specific 5-year prediction, XGBoost achieved an AUC of 0.8505 in the internal test set.

The gain

Models trained on clinicopathological features discriminated which oral leukoplakia patients would develop malignancy within 5 years, which may support individualized risk stratification.

The rundown

The study was a retrospective cohort of Chinese oral leukoplakia patients, a potentially malignant oral disorder with a reported transformation rate of 7.2 to 9.8 percent. The aim was to identify factors linked to malignant transformation and build prediction models.

Six methods were compared: Logistic Regression, SVM, Random Forest, GBDT, XGBoost, and LightGBM. The 672-patient dataset was split into training and internal test portions, and a separate temporal cohort had 24 transformations among 73 patients.

The authors state that the temporal validation results should be interpreted with caution because of limited sample size, and that larger multicenter cohorts are needed before clinical application.

Sources

  1. Peer-reviewedOral Oncology2026-10-17

The debate